Sluggish Cognitive Tempo

What is Sluggish Cognitive Tempo?

Sluggish cognitive tempo (SCT) is a syndrome related to attention deficit hyperactivity disorder (ADHD) but distinct from it. Typical symptoms include prominent dreaminess, mental fogginess, hypoactivity, sluggishness, staring frequently, inconsistent alertness and a slow working speed.

SCT is not an officially recognized diagnosis. It’s currently labeled a clinical construct and emerged nearly four decades ago. This is a term used in psychology to define a group of behaviors.

How SCT Compares with ADHD

The symptoms of SCT are similar to those of the inattentive subtype of ADHD and include:

  • Excessive day dreaming
  • Lethargy and / or drowsiness
  • Poor memory retrieval
  • Trouble staying alert in less stimulating situations
  • Slow processing of information
  • Behaving in a
  • Easily confused
  • Difficulty expressing thoughts
  • Depression and / or anxiety

In face, about 50% of all patients diagnosed with SCT also have attention deficit disorder and 30-63% percent of patients with inattentive-type ADHD also have high levels of SCT.

Though the symptoms of inattentive ADHD and SCT overlap to some degree, a number of researchers have been advocating for a separate diagnosis since the mid 1980s.

How SCT is Diagnosed and Treated

While SCT is not in the DSM-5, a diagnosis can be made by a trained psychologist or psychiatrist. The diagnosis is typically made though observations and questionnaires filled out by family members.

Treatment follows a pattern similar to that for ADHDwith a combination of:

  • Stimulants to help with focus and attention
  • Antidepressants to ease anxiety or depression.
  • Therapy to help with processing information, organization, and social skills
  • Implementing good sleep habits, a healthy diet, and regular exercise to help with drowsiness during the day, and improve concentration

Treatment is important as some initial longitudinal studies have shown that SCT in childhood or adolescence predicts increased levels of depression and inattention in adulthood which can negatively affect the quality of life.

The Future of SCT

The scientific jury is still out on whether SCT deserves its own diagnosis separate from ADHD, Some critics argue that SCT “pathologizes” too many traits once considered normal and its symptoms are associated with too many other conditions – e.g., hypothyroidism to depression. While its future as a clinical diagnosis may be in limbo, the symptoms associated with SCT are very real and deserve to be evaluated for treatment.




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